肺微生物组,免疫反应和呼吸机相关肺炎代谢的纵向分析:一个队列研究
Ingrid G Bustos1,2, Cristian C Serrano-Mayorga1,2,3, José L Guerrero4
1Unisabana Center for Translational Science, School of Medicine, Universidad de La Sabana, Chia, Colombia.
机械通风改变了肺部微生物组的组成. 呼吸器相关性肺炎 (VAP) 病例显示TNF-α和无氧代谢较高,而IL-1β随着通风本身的增加而增加.
科学领域:
- 肺部医学 肺部医学
- 微生物学 微生物学
- 代谢学 代谢学 代谢学
背景情况:
- 呼吸机相关性肺炎 (VAP) 是侵袭性机械通风 (IMV) 患者的常见并发症.
- 推动VAP发展的确切机制尚不清楚.
- 这项研究探讨了IMV患者肺微生物组,炎症和新陈代谢的相互作用,以确定VAP风险因素.
研究的目的:
- 确定肺微生物组,炎症标志物和代谢特征的变化与IMV患者的VAP发育的相关性.
- 研究IMV对肺部微生物群落和宿主反应的影响.
- 要区分VAP特有的变化和机械通风引起的变化.
主要方法:
- 招募需要IMV治疗非传染性呼吸衰竭的患者.
- 在基线和随访点收集支气管支气管洗 (BAL) 样本.
- 通过DNA测序,细胞因子水平和代谢分析分析肺部微生物组合.
主要成果:
- 在研究的80名患者中,51%的患者出现了VAP.
- 在VAP和非VAP组之间没有发现肺微生物群多样性的显著差异.
- VAP患者表现出肺瘤缩因子-α (TNF-α) 的升高;所有患者都显示出白蛋白-1β (IL-1β) 的增加.
- 代谢分析表明,VAP患者转向无氧代谢.
- 在所有IMV患者中,无论VAP状态如何,都观察到微生物组合的时间变化.
结论:
- 侵入性机械通风诱导肺微生物组合的时间变化,独立于VAP.
- 提升的TNF-α和暗示无氧适应的代谢变化是VAP的特征.
- 增加的IL-1β水平似乎是对机械通风的反应,而不是VAP感染.
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